14:36,6,Oct,2010 | (2073/0/0) | Original

epispadias cloacal exstrophy complex

Eversion bladder is what causes it?
(A) etiology
On the etiology of bladder eversion, the current multi-embryonic development that occurs due to the error, rather than a certain stage of development of the pause, because the human embryos usually do not undergo bladder eversion stage.
(B) of the pathogenesis
Valgus deformity of the bladder is based on the embryology of the abnormal development of the cloacal membrane, impeding the Department of mesoderm tissue shift to the center so that the next developmental disorders abdominal wall. Cloacal membrane rupture defect, the formation of various forms of bladder eversion and hypospadias (Figure 1).
Figure 2 bladder eversion (Schematic)
Bladder valgus deformities, mostly compound, a common deformity is associated with epispadias and cloacal eversion. Because the bladder and urethra is homologous in the embryonic development with the Department, the most common abnormality is the urinary bladder eversion compound - epispadias.
In addition, some patients only the development of abdominal wall defects in skeletal muscle, and urinary tract development is complete, a condition called pseudo-bladder eversion (pseudo exstrophy); main characteristics of the umbilical cord is too long, umbilical low rectal muscle dispersed attached to the pubic bone (Figure 2).
What are the performance and eversion bladder diagnosed?
One. Symptoms
Bladder eversion is rare, the majority of children at an early age because of urinary tract infections and death row aisle. Some children with abdominal wall defects, bladder eversion nudity, color red, extremely sensitive, easy bruising bleeding, shows bilateral ureteral orifice slightly raised paroxysmal urination, underwear wet stains, with the urine smell, lower abdominal wall, perineum, inner thighs, the skin may appear dermatitis or eczema. Eversion of bladder size vary widely. Early bladder smooth valgus may be due to long-term exposure, mechanical friction and the formation of villi, polyps, or squamous metaplasia occurs, the bladder wall thickening due to detrusor fibrosis and hardening.
II. Diagnostics
According to patients symptoms and signs can be confirmed:
1. Children underwear wet stains, with the urine smell, Changcheng swinging gait.
2. The next part of abdominal wall defects, bladder eversion, bright red, sensitive, easy bleeding, ureter mouth exposed, burst bladder, pubic symphysis separation.
3. Boys with epispadias, penis; girl clitoris, labia minora anterior commissure separation.
4. Associated with upper urinary tract or other organs of the body deformities.
5. Rule out pseudo bladder eversion urinary bladder eversion on the crack or repeated.
What should be done bladder eversion check?
1. Plain film: pelvic dysplasia, pubic symphysis completely separate, separate, and sacral width width of about equivalent to the pelvis open horseshoe, the two femoral external rotation.
2. Urography:
the bladder drops down.
It should be noted with malformations, intravenous urography do understand the situation on the urinary tract, B-ultrasound kidneys, ureter have deformities. Renal nuclide scan, the renal function, renal blood flow. Conduct a comprehensive inspection to see whether the normal heart and lung function.
The diseases of bladder eversion easily confused?
False bladder eversion: This is complete epispadias plus bladder prolapse. The umbilicus position is low, the rectus abdominis split from the umbilical, attached to the separation of the pubic bone, bladder, like highlights from the split of the rectus abdominal hernia, but the urinary tract is normal.
What can be complicated by hallux valgus bladder disease?
Abdominal muscle abnormalities in children may be due to concurrent inguinal hernia; for pubic symphysis separation, pelvic abnormalities occur or femoral dislocation of the hip external rotation, rocking gait of children were walking. Bladder eversion may be associated with spina bifida in children, Tixing kidney, cleft lip, cleft palate, anus forward, atresia, rectal prolapse and other deformities.
Male penis growth in children is poor, varying degrees of epispadias, flat glans, the foreskin accumulation in the ventral. Separated by more combined penis penis bend, so penis. May be associated with cryptorchidism. Separation of female clitoris, labia minora anterior commissure on both sides of the belly of the line separation, vaginal opening forward. Fertile, flat prone to postpartum uterine prolapse. There are long-term complications of bladder eversion vesicoureteral reflux, recurrent urinary system infection and stones.
Eversion of the bladder anterior wall of the bladder and the anterior abdominal wall defects, bladder mucosa of the posterior wall of the abdominal wall skin edge and connected, then the posterior wall of the abdominal wall defect in the fontanel. Bright red color of the exposed bladder mucosa, easy bruising bleeding, accompanied by pain, and because of chronic inflammation and long-term mechanical stimulation, can epithelial degeneration, and even malignant transformation. Slightly higher in the posterior wall can still see the urine from the ureteral orifice have intermittent spray. Regular urine soaked the surrounding skin, causing dermatitis or eczema. Most of the sick child at an early age because of urinary tract infections and death row aisle. Almost all bladder eversion combined epispadias and pubic symphysis separation, or with hip dislocation.
How to prevent bladder eversion?
Prevention of common sense:
All surgical repair of this disease and surgery, aims to restore anatomical form and protection of renal function, control urination. However, many surgical procedures, and according to their age and physical condition of step by step. Therefore, in addition to surgery as soon as possible, but also can not ignore the complexity of the procedure and the possibility of failure, the parents should be mentally prepared, in close cooperation with the care, strengthening the observation and care. Even if the operation is successful, follow-up review must also pay attention to whether the upper urinary tract dilatation, reflux or infection. Another of the disease and 10% of children suffering from urinary incontinence can not control or operation because of failure to be done to urinary diversion surgery.
Bladder eversion should be treated?
(A) treatment
Treatment aims to protect renal function, urinary control, repair the bladder, abdominal wall and genitalia. Surgical repair of female than males.
Fibrosis of the bladder wall and bladder wall edema long-term exposure and chronic inflammation, it should be done within 72h after birth simply turn the bladder suture. If not for the pelvic osteotomy can be put back in the bladder after pelvic fascia and the pubis midline suture fiber cartilage tissue. If too wide spacing of the pubic symphysis, it is estimated not suture, the surgery postponed until 7 to 10 days after birth for the pelvic osteotomy and varus bladder suture. After the initial successful closure of the urinary bladder capacity and control is very important. Suture should be turned in the bladder fistula indwelling bladder 3 to 4 weeks, without urethral stent was placed, 3 to 4 weeks after application of traction to prevent wound dehiscence Bryant. Such as the children recovered well, to 1.5 to 2.5 years of age in the measurement of bladder capacity under anesthesia, such as the bladder capacity of more than 60ml, which can repair the bladder neck and epispadias, such as the capacity of 40ml the following, only the repair epispadias, so that increase capacity to 3 to 5 years old and then repair the bladder neck. In the repair epispadias 5 weeks before the intramuscular injection of testosterone propionate (testosterone propionate) 2mg/kg, make penis enlargement, this effect disappeared 4 weeks after surgery. Application of Young-Dees-Leadbetter bladder neck surgical repair may need intermittent catheterization.
Be followed up cases of upper urinary tract surgery, with or without reflux, obstruction and urine emptying. Review after 4 months of intravenous urography and voiding cystography to detect whether the upper urinary tract dilatation, reflux and presence of residual infection. Check the flow rate of bladder neck repair can help diagnose urinary bladder emptying without obstruction.
If the bladder capacity of small children, older children or surgery, patients still can not control urination, need to consider bladder augmentation or change the flow control urinary tract surgery.
Complicated by postpartum women with uterine prolapse, because the vagina to be shallow, weak pelvic floor, bladder neck surgery and had received the best post-cesarean section appears to prevent urinary incontinence.
(B) prognosis
If not treated 2 / 3 of cases before the age of 20 died of hydronephrosis and urinary tract infections. Short-term postoperative complications included urethral fistula, urethral stricture, and skin breakdown. Lapor and Jeffs (1983) reported 22 cases restored by function, 18 patients (86%) to control urination. Yerkes and other 53 cases (35 cases and 18 cases of typical valgus bladder epispadias) after long-term follow-up results showed that 18 cases of bladder control can be good, but 72% had poor bladder emptying due to a series of complications , including 10 cases of urinary tract infection, epididymitis in 2 cases and 4 cases of bladder stones. Pelvic osteotomy recurrence of pubic symphysis separation could occur, Ozcan et al (2000), 10 patients were followed up for 14.8 ~ 49.5 months (mean 34.6 months), 9 cases were recurrence of pubic symphysis separation occurred.

epispadias cloacal exstrophy complex

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Anatomy of the bladder
Bladder cancer is the most common cancer in developed countries or regions have a higher prevalence. Abroad, the incidence of bladder cancer in the male urinary and reproductive system cancers after prostate cancer, ranking No. 2; in the country accounted for first place, and there is increasing trend in recent years. Bladder wall from the inside out into mucosa, submucosa and muscular layer. In the muscular layer of fat outside the cell into the bladder tissue and cover the top? Department of the membrane. The bladder wall can be divided into triangle, triangle after the area, neck, sides and anterior wall. Connection between the ureteral orifice bottom line for the triangle. Triangle is a major part of the bladder lumen. Most bladder cancer occurs in the triangle, both sides of the wall and neck. Detrusor muscle and bladder by the triangle formed by the muscle, the detrusor smooth muscle fibers to each successive cross-network structure, muscle fibers were arranged into three layers: the inner and outer longitudinal muscle system, the middle is a circular muscle. The arterial supply of the bladder from the internal iliac artery branches sent the upper and lower artery, obturator artery and the pudendal artery branches. Bladder venous plexus around the base of the bladder, is the largest pelvic venous plexus. In men, the venous plexus around the bladder and prostate, collecting bladder, prostate, seminal vesicles and vas deferens of the venous blood flow back into the internal iliac vein; in women, to collect the bladder, urethra and vagina of the blood into the iliac vein. Bladder lymphatic flow to the iliac, internal iliac and sacral lymph nodes.
Introduction to Bladder Cancer
I. Overview
Urinary bladder cancer is the most common reproductive system cancer tumor, the incidence was increasing in recent years. Epithelial tumors in the urinary tract, bladder tumors account for the highest incidence.
Second, the pathological
Bladder cancer can be divided into two categories, namely, from non-epithelial tissue epithelial tissue and tumors.
1. Epithelial tissue from the tumor, including transitional cell tumor, adenocarcinoma and squamous cell carcinoma, 98% of bladder tumors from epithelial tissues, including transitional cell tumors account for 95%.
(1) transitional cell tumors: including carcinoma in situ, papilloma, papillary carcinoma and solid carcinoma. The latter two also appear in a tumor, known as papillary solid carcinoma. This classification is for clinical application, but the tumor biological behavior, they're all at different stages of a disease or at the beginning of the continuous development alone when there is a very contentious issue.
a. Carcinoma in situ, is a special transitional epithelial tumors confined to the start of transitional epithelium, which formed slightly protruding villous red pieces, do not infringe the basement membrane, but the poorly differentiated cells, loss of adhesion between cells, so cells easily fall off, and easy to check from the urine. Difficult to predict the natural course of carcinoma in situ, and some long-term asymptomatic, does not appear invasion, some developed very quickly to the development of invasive carcinoma in situ of the time normally takes 1 year to 5 years, 20 years, and it was felt There are two forms of carcinoma in situ represents an invasive ability of carcinoma of the predecessor entities, but no infiltration capacity of another, called the contradiction cancer, is relatively benign.
b. Papilloma is a benign tumor seen histologically normal bladder mucosa from the source, as plants like broke into the bladder, with a slender pedicle, which shows clearly the center of fibrous tissue and vascular bundles. The characteristics of papilloma recurrence, the recurrence rate was 60% within 5 years, 48.6% of them relapsed more than twice. Necessary after cystoscopy followed up regularly.
c. Papillary carcinoma, transitional cell tumors in the most common. Pathological feature is the integration of the nipple chunky, not smooth the surface of tumor, necrosis, or a calcium calm, tumor basal pedicle width or chunky. Sometimes, such as small papillary carcinoma or long fist, but still retain a pedicle, on the other parts of the non-invasive. Although this form is rare, it should be noted, in order to avoid unnecessary radical cystectomy.
d. Solid carcinoma, transitional cell tumors in the most vicious, uneven surface, no obvious nipple formation, collapse of the surface of tumor material, the high edge of collapse material, the surface of nodular early to the depths of the infiltration, it is also known as the infiltration carcinoma. A variety of transitional cell bladder transitional epithelium may occur in different situations, in simple epithelial hyperplasia without epithelial dysplasia to the development of cases for the superficial papilloma; as hyperplasia and dysplasia can be developed simultaneously highly malignant papillary carcinoma; if simple hyperplasia without dysplasia, flat carcinoma in situ may develop into transitional cell bladder cancer recurrence is a recurrence of the problem or tell sometimes Shennan new tumors. The so-called relapse, there may be three reasons:
â‘  continue to suffer from urinary bladder epithelium of the carcinogenic substances, reflecting the instability of the bladder epithelium and has a potential range of epithelial changes;
â‘¡ recurrence often appears in the top of the bladder or bladder incision, indicating that the tumor cells because of the free cultivation;
â‘¢ the original tumor is not removed or left clean and that the tumor is not the naked eye.
(2) adenocarcinoma: also known as adenoid carcinoma, mucinous adenocarcinoma or signet ring cell carcinoma of the bladder tumor is rare. Bladder cancer more common in the triangle and the top of the wall. Adenocarcinoma of the bladder often originated in triangular glandular cystic cystitis or bladder inflammation. The glandular and cystic cystitis related to the development and cloaca, as in the embryonic period, separating the urogenital sinus cloaca and rectum, if the intestinal mucosa at the dividing line was left at the side of the urogenital sinus, the future may appear, and glandular epithelium may occur, or cystic glandular cystitis. Also caused by chronic stimulation of the glandular metaplasia of transitional epithelium. Adenocarcinoma at the top of the bladder urachal remnants of origin, location hidden symptoms often have been to late. Metastatic adenocarcinoma of the bladder can also occur, may come from the rectum, stomach, endometrial, ovarian, breast or prostate cancer such as primary, of course, very rare, autopsy reports in 5000 accounted for 0.26%.
(3) squamous cell carcinoma of the bladder: are rare, Taiwan has 12 reports of bladder cancer accounts for 0.58% to 5.55%. Bladder transitional epithelium in a variety of stimuli can be as squamous metaplasia. There are reports that focal squamous metaplasia of 60%, but the main is still transitional cell carcinoma, and only appeared in the same tumor pathology departments only when a diagnosis of squamous cell carcinoma. Many domestic bladder stone associated with bladder cancer reported. In general, squamous cell carcinoma of bladder transitional cell carcinoma than in high malignancy, the development of fast, deep invasion, poor prognosis.
Clinical manifestations of bladder cancer
1, no obvious early symptoms.
2, late hematuria, urinary frequency, dysuria, or urinary obstruction, dysuria;
3, there urinary retention, weight loss, loss of appetite; abdomen, back pain, persistent fever, anemia.
Bladder cancer risk factors
1. Chemical carcinogens: long-term exposure to the types of aromatic substances, such as dyes, leather, rubber, painters and so on.
2. Endogenous tryptophan metabolism in bladder cancer relationship may consider the normal metabolism of tryptophan accumulation of the intermediate metabolites belong to the o-amino phenol hydroxyl.
3. Smokers than non-smokers the risk of bladder cancer 4 times as large, because tobacco contains specific carcinogen.
4. Have done things radiotherapy or alkylating chemotherapy crowd.
5. Salted and smoked meat consumption may be associated with bladder cancer. Caffeine, saccharin and other consumption is associated with it.
6. Long-term use can increase the analgesic phenacetin rate of occurrence of cancer. Parasitic disease, chronic bladder infections, viral infections, and so on.
Bladder Cancer Important
1. Urinary bladder cancer is the most common cancer, the incidence increased significantly in recent years, a good age at 50 to 70 years old, male to female ratio was 4 ︰ 1.
2. Gross hematuria ﹑ ﹑ bladder irritation is the main symptoms.
3.90% of bladder cancer is transitional cell carcinoma, a small number of squamous cell carcinoma ﹑.
4. Local recurrence of bladder cancer recurrence several characteristics common liver metastasis lung ﹑ ﹑ ﹑ dirty bone.
5. Because the anatomical characteristics of the bladder, the local treatment of bladder cancer successfully completed easily, so the effective systemic treatment to prevent recurrence of bladder cancer is the focus of clinical study, most comprehensive treatment can be long-term survival of early bladder cancer.
6. Bladder cancer is the local performance of systemic disease, early detection of specific anti-cancer ﹑ ﹑ ﹑ comprehensive treatment ﹑ individual treatment of systemic administration is the basic principle of treatment of bladder cancer should be treated consistently throughout.
7. Good postoperative care, daily local wound cleansing and disinfection to maintain voiding ﹑ ﹑ ﹑ active exercise to prevent urinary tract infection, urinary function, urinary difficulties encountered when admitted to the hospital, active treatment.
8. The first 2 years review once every 3 months urine ﹑ ﹑ B-CT, if necessary, for cystoscopy.
9. Treatment plan should be detailed in the understanding of patient's condition, including the radiation dose ﹑ ﹑ voiding function operation time to develop and implement scientific and effective treatment, most patients with bladder cancer resulted in higher long-term effect.
10. Prognostic classification of tumors and clinical stage ﹑ ﹑ ﹑ whether the multiple tumor histological grade and whether the road obstructive urinary diseases related to 5-year survival rates of different stages were T1, is 63%; T2 of 21% ; T3 period is 10%; T4 period is 0%.
Simple method to detect early bladder cancer
A study from the United Kingdom, on the urine of a cancer-related protein was detected urine test may be better than the conventional detection of bladder cancer. Soeber University College London and colleagues in the JNatlCancerIt (2002,94:1071) reported on the study.
Currently, inspectors mainly by means of cytology, which look for abnormal cells in the urine method for diagnosis of bladder cancer. Cytology is often easy to have a large number of abnormal cells detected in well-differentiated tumors, but the detection rate of poorly differentiated tumor is not high, because in this period, the number of abnormal cells is very small. Cystoscopy is the gold standard for diagnosis of bladder cancer. However, Stoeber so that cystoscopy is invasive operation, and check the high cost, many patients with atypical symptoms of urinary tract may be unnecessary to accept cystoscopy. Stoeber new methods such as micro-chromosome designed to detect urinary protein 5 (Mcm5) level. Stoeber's group has found that cancer cells have abnormal expression of proteins in this series.
Of all the urine samples are accepted cytology. In the urine of patients leave within 12 hours after receiving the upper urinary tract imaging and cystoscopy. Cytology test in the detection and Mcm5 checkpoint with the same specificity, Mcm5 than urine cytology test has a more significant statistical sensitivity (73% vs 48%). The detection limit in the study, in 353 patients showed similar symptoms of bladder cancer patients, the researchers detected by Mcm5 92% and recurrence of bladder cancer cases. However, the report noted, Mcm5 detect the same 22% of the false positive rate. Stoeber so that the accuracy rate in this level, the detection means can detect early stage bladder cancer. In addition, they said that this method can also be used to detect well-differentiated tumors. Stoeber said: "This detection method can detect various stages of differentiation of various degrees of bladder cancer, even those who missed the tumor by urine cytology. The study one of the most important result is that the protein in the bladder can be achieved early diagnosis of cancer. "Although the study of bladder cancer, Stoeber's team found Mcm5 Another advantage of testing: study of 12 patients were eventually diagnosed with prostate cancer, they also have Mcm5 of urine increased.
Researchers believe that this method has applied to the detection possibility of other types of tumors.
Bladder cancer based care
Bladder cancer patients to pay special attention to the diet, exercise control of the new urinary bladder capacity, after the short term, may be due to urethral sphincter bladder capacity is small or parts of edema and function of the affected and other reasons, appear more times urination, urinary poor, even the case of urinary incontinence. Should be more water, adhere to the levator ani or anal contraction exercise to exercise urethral sphincter function, early recovery of urinary bladder capacity. Regular emptying of the bladder, to prevent bladder over-filling capacity of decompensation, to reduce re-absorption of urine and reduce waste such as metabolic acidosis complications, must be regularly ranked bladder. No matter whether you want the feeling of urination should urinate every 2 to 3 hours once, and strive every time to completely empty the bladder, urination at night at least 2 times. Standing urination difficulty, can be squatting or sitting urination urination. Contraction of abdominal muscles when urinating, abdominal breath holding force, or by hand push to increase intra-abdominal pressure to help urination.
Home catheterization: For more than a few residual urine are required to self-catheterization.
Vulnerable to recurrence of bladder cancer patients, but if timely treatment after relapse can still be cured, so the bladder cancer patients should always check, if early detection of recurrence can be, generally every three months for a cystoscopy.
Have some appropriate diet, prevention and treatment of great benefit bladder cancer, several are described below for reference.
1, yi 30g, Chixiaodou 30g, gruel boiled food, uniforms, anti-cancer anti-cancer.
2, white fungus 20g, water stew served, 1 day, cancer prevention of cancer.
3, fresh purslane 120g, rabbit meat 250g (cut), plus Shuizhu Shu, salt, Yin Tang meat, dressed in uniforms, anti-cancer anti-cancer.
4, lOOg rice porridge. Transferred Lingfen 30-50g. Amount of brown sugar, eat cancer.
5, loofah 100 (Wash scraping peeled, cut into pieces), duck pieces lOOg. Add seasoning the cooked food, to heat dampness detoxification, prevention and treatment of bladder cancer.
6, fresh grape juice lOOg, fresh lotus root juice lOOg, fresh juice habitat 60g, put jar in the boiling mixture, transferred amount of honey and warm clothes can be used for bladder cancer, hematuria and dysuria.
7, lOOg of fresh radish slices, salted with Baimi for a while, let dry iron on the Sunburn, Sunburn and then dipped in honey again, to? 50g white Mizhi do. After cooling, slowly, drink two salt water, cure bladder cancer dysuria.
8, sugarcane 250g (chopped small pieces), Rhizoma Imperatae 100g cut into small pieces, shared cloth, with green beans? 100g water cook until beans Shulan to sugarcane and Chine, Yin Tang fresh beans, can increase amount of crystal sugar, hematuria for bladder cancer with obvious.
9, Chixiaodou 30g, rice 50g, a total of porridge. Gallus gallus domesticus when cooked into the end of the 15g, then you can boil into a porridge, breakfast eaten, assisted treatment of bladder cancer, urinary tract infection caused by pain, leg pain.
10, 1 watermelon, 1 cup raisins, watermelon near the pedicle cut a piece: Wash and drain the raisins to dig into the flesh in the loose, and then cut the melon block cover; paste in clay seal in cool place until 10 days after the removal of mud, torn off the lid, pour the juice, that is, contain trace amounts of alcohol, fragrance of sweet wine, can be used for bladder cancer and edema, or difficulty urinating.
New Study: Women more likely salesman bladder cancer International Online News: New Zealand Massey University researchers in recent years through the study found that people who work in sales suffering from bladder cancer risk may be higher than other industries, higher chances of employees This is the saleswoman who is particularly evident.
Reuters reported on April 27, after a number of studies have shown, in the hairdressers, textile workers, truck drivers, and in rubber, leather and chemical enterprises in the work of people suffering from bladder cancer risk is higher. But in the past 20 years, a series of studies also found that people suffering in the sales of the possibility of bladder cancer as above average. Responsible for carrying out this research work is from Massey University in New Zealand An Deli Yama Nai Teye Dr. Pierce and Dr. Neil. The analysis they found that other factors are taken into account in the premise, the work of women to become engaged in sales patients with bladder cancer more likely than employees in other industries 18% higher. But for men, the situation is different, so the sales and the risk of bladder cancer does not exist between the links of a comprehensive and clear. The researchers also pointed out that there are some indications that the men engaged in auto sales will face a higher risk of bladder cancer risk.
Manaiteye told Reuters in an interview that has yet to figure out in the sales and the risk of bladder cancer is between the existence of a clear causal link. She said: "The research done on the previous re-evaluation is to show people that those who suffer from female sales staff risk of bladder cancer is relatively higher, but the increase is not great." Manai Te Jesus further explained that there is a speculation is that the sales staff at work on a relatively small number of toilets, but also less water, which makes those present in the urine may cause cancer of various substances time spent inside the bladder will become longer, and that there may increase a person's likelihood of bladder cancer. The final results have been published in the United States, "Journal of Industrial Medicine" on
New research shows that the United Kingdom: passive smoking of children susceptible to bladder cancer, the latest issue of "International Journal of Cancer," published a study reported that passive smoking of children growing up troubles will increase the risk of bladder cancer. The researchers analyzed a large number of comparative clinical data concluded that, the people of passive smoking in childhood adulthood risk of bladder cancer is higher than the others 38%. The results also showed that every 5-year delay to start smoking, the odds of suffering from bladder cancer decreased by 19%. In other words, the smaller the age of smoking initiation, risk of bladder cancer risk is higher.
One of the authors of the report, Naomi Allen of Oxford University, an expert pointed out: "the results of many previous studies have showed that the risk of bladder cancer and smoking a lot, but this research is the more prominent young The troubles in the adult passive smokers a better chance of bladder cancer. "
On average, active smokers suffering from bladder cancer risk is 4 times higher than non-smokers, and, smoking more frequently, the longer the smoke, the higher the chance of illness. Smokers who have been sick twice the risk of non-smokers, of course, would be as likely to quit smoking prevalence increased with time, slowly decrease. Allen said: "This shows that the effect is to quit."
Cancer Research UK expert John Toy said: "Although more research is needed to confirm a child the consequences of passive smoking, the findings of the study or for the Government introduced the ban on smoking in public places provide a strong basis for the provisions. "
New research shows that: a cup of coffee may protect against bladder cancer
A new study shows that coffee can prevent smoking-induced bladder cancer. Preliminary studies have shown that half of patients with bladder cancer are smoking, but they do not drink coffee. This suggests that coffee may have some impact on tobacco. Almost everyone that the reduction in the incidence of bladder cancer, the best way is to stop smoking.
Studies have shown that smokers of its coffee was still the occurrence of bladder cancer is to drink coffee 3 times the non-smokers, but smokers do not drink coffee, its incidence of bladder cancer is to not smoke do not drink coffee 7 times those who smoke. The study found that a few years ago, is the difference between a cup of coffee is that drinking a small amount of coffee can reduce the risk of bladder cancer, but this found only in non-smoking population has been reflected.
Smoking is a major cause of bladder cancer. Data shows that people in bladder cancer, 50% of men and 30% of the women are from smoking Erzhi. Tobacco increases the risk 2-5 times the risk of bladder cancer, and this risk will continue to 2-4 years, and drinking coffee may reduce this risk.
By 1100 the Spanish people without disease research, so that they develop the habit of smoking and drinking coffee, the results show that those who drink two cups of coffee a week than those who never drank coffee, their risk of bladder cancer significantly lower.
Six diseases often cause holding back urine
1. Urinary tract infection: a long time holding back urine within the bladder urine will have piled up, bacteria and toxic substances with the urine failed to discharge, it is easy to cause cystitis, urethritis and other diseases. In severe cases, urinary tract infection can spread upward to the kidneys, causing pyelonephritis, and even affect renal function.
2. Rise to the "heart" disease: in holding back urine caused by physiological and psychological factors in the double role of stress, hypertension patients blood pressure, heart rate, coronary heart disease appears angina, arrhythmia and other symptoms, but also may be the onset of cardiovascular diseases incentives can lead to sudden death seriously.
3. Bladder injury: the nerve that controls bladder contraction of the muscles located in the bladder wall, the holding back urine for too long, cause nerve ischemia or excessive pull of the damage, causing pain in urination, frequent urination or urine is not clean and other sequelae. If severe nerve damage, bladder sphincter weakness, or even result in no row of the consequences of urine.
4. Evoked micturition syncope: micturition syncope occurred in 20 to 30 year-old male, and occasionally in the elderly, mainly sudden, forced voiding caused by increased intrathoracic pressure, leading to cerebral ischemia. In addition, the cold weather and holding back urine that the bladder urine too much time in the rapidly emptying, caused by vagal reflex bradycardia can also be induced by micturition syncope.
Beware of holding back urine micturition syncope
5. Bladder cancer: study abroad, data show that frequency of urination and bladder cancer incidence is closely related to frequency of urination less risk the greater the risk of bladder cancer. Because of increased holding back urine of bladder cancer-causing substances in urine duration of action, there is habit of holding back urine bladder cancer more likely than the average person 3 to 5 times.
A new study by U.S. scientists found that by eating nuts, olive oil and other food intake of adequate vitamin E, can reduce the risk of disease . eat more nuts and vegetables protect against bladder cancer.
6. Prostatitis: a study shows that men one of the major causes of prostatitis, urinary tract bacteria is the tube retrograde through the prostate to the prostate, caused by infection, leading to prostatitis.
Experts advise: get rid of problems caused by holding back urine is recommended that you note the following:
1. In each before going out best to solve the problem of what to urinate.
2. Whether it is work, study or during the session, there should be a "break" time, so that their "convenience" it.
3. Simmer for some time in the urine, except for emptying the bladder as soon as possible, the best way is to add a lot of water, force yourself to urinate more than a few times, which is a wash for the bladder, the bladder can be avoided the proliferation of bacteria.
In addition, should pay attention to lower body warm in winter and less drinking and eating spicy food. For the prevention of micturition syncope, in addition to not holding back urine when sleeping outside, get up to urinate, the best to sit a while in bed, then stand up and walk again.
Detection of hTERT expression can predict recurrence of bladder cancer
Recently, Department of Urology, Xijing Hospital, Fourth Military Medical University, completed a study found that tendency of recurrence? Bladder cancer? Patients with telomerase reverse transcriptase gene (hTERT) expression was significantly higher than those without recurrence, suggesting that expression of hTERT gene anomaly can be used to predict the potential tendency of recurrence of bladder cancer indicators.
And urinary bladder cancer and harmful gases from time to time on
New Zealand Occupational Safety and Health Service recently issued a warning truck drivers and other employees, must pay attention to voiding time, and avoid inhalation of harmful gases, because the study found that these two factors connected with the occupation and the risk of bladder cancer are closely related.
Starting from January 2001, the center's researchers studied 123 cases of bladder cancer patients and found, of which 33 (or 27% of patients) the occupation is considered to be easily induced bladder cancer, such as truck drivers, particularly drivers of long distances, due to work reasons, they often can not empty the bladder in a timely manner, which is easier than most people get on the bladder cancer. In addition to not been able to urinate, truck drivers also inhale more harmful than ordinary gas, such as car engines emit exhaust fumes and road, these harmful gases to allow the driver to increase their risk of bladder cancer. In addition, similar to truck drivers engaged in engineering and metal industry workers, peasants, farmers and gardeners have the opportunity because of excessive inhalation of harmful gases, making it a high risk of bladder cancer.
Swiss researchers say that part of bladder cancer with genetic
Swiss researchers reported that people with parents or siblings? Bladder cancer? The individuals themselves have more than ordinary people's suffering from bladder cancer risk.
According to the Swedish Karolinska Institute researchers report the findings further confirmed bladder cancer - the United States and Western Europe in the fourth most common cancer in men, at least partially hereditary. Bladder cancer, another known risk factors for smoking. "Despite the genetic and environmental factors have a role in bladder cancer, but the incidence of bladder cancer in the family, we understand still less." Kamila Plna and Kari Hemminki wrote in an article. Study, the scientists re-examined more than 2,000 descendants of the incidence of bladder cancer cases, found the cancer before the age of 45 male patients, their brothers and the highest risk for the normal male brother 7 times.
Sick parents, the son of bladder cancer bladder cancer risk than offspring of normal parents, 35% higher. The daughter of sick parents, the risk of bladder cancer is higher than the normal parents, the daughter of 2 times. Overall, siblings of individuals with bladder cancer, the risk of bladder cancer risk than individuals of normal siblings is 3 times higher, researchers will be published in the December 2001 issue of "Journal of Urology" (The Journal of Urology) on.
Bladder cancer incidence in men than women, 3 to 4 times higher, while the highest incidence in elderly men. The author believes that the high incidence of males may be due on the X chromosome, a cancer-related genes. Because men have only one X chromosome, so they carry two X chromosomes than the female X chromosome are more vulnerable to the impact of mutations. Plna and Hemminki finally concluded that: "our compatriots in the high-risk offspring and the gender-specific effects we found may reflect the X chromosome there is a bladder cancer susceptibility gene."
Strong "micro" search for signs of early cancer
If we can make cancer cells in early overt, then the patient will be less subject to a lot of pain; If you let a little faster data transfer, online watch online movies will not suddenly get stuck . While these ideas are at the assumption stage, but scientists have been quite confident on this. The reporter learned from yesterday's Eastern Science and Technology Forum was informed that the use of nano-scale optical technology, similar to many of the dreams will come true. An expert meeting told reporters that the so-called nano-optics, refers to the scale of atoms (molecules) and micro optical phenomena between the studies, although it sounds very boring, but there is very broad application prospects. Using nano-optics, to create a special fine instruments of observation, it can make those small cells completely "profiling" will not only facilitate treatment can significantly reduce the suffering of patients.
British scientists found that cancer cell proliferation regime: British scientists have found two proteins in human blood cells play an important role in the proliferation mechanism. University of Liverpool 8, a press release that the university researchers found that human blood called "epithelial mucin 1" (MUC1) in a large protein will form a protective shield around cancer cells and prevent cancer cell proliferation; other called "galactose-binding protein 3" (GALECTIN-3) of the small protein, it will attack "epithelial mucin 1", destruction of protective shield, making the cancer cells spread throughout the body.
The researchers said cancer cell adhesion to the vascular wall is a key step in the spread of cancer cells, and epithelial cell surface adhesion protein-1 can prevent the cancer cells attached to the vessel wall, but the galactose-binding protein 3 will attack epithelial mucin 1 large area exposed to cancer cells, so cancer cells can be attached to the vessel wall and eventually penetrate the vessel wall and spread to other sites.
For years, scientists in the blood of cancer patients are known galactose-binding protein 3 concentrations higher than in healthy people, but had been unclear galactose-binding protein 3 in cancer cells to spread, how to play a role. The researchers said the findings may in the future development of cancer drugs is important.
Stem cells in the "silent" cancer gene sow "seeds"
University of Southern California researchers has confirmed the stem cells and cancer relationship. They found that in embryonic stem cells by reversible inhibition of the gene is expressed genes in fact, they belong to the tumor "permanent silence" the gene part. The link between cancer stem cells derived from the theory of small to provide strong support. Related research will be published in the latest issue of "Nature Genetics" magazine.
The researchers looked at were "Polycomb" inhibiting protein of 177 genes and found that 77 showed enzymes and DNA modification of cancer-related signs, also known as the problem of DNA methylation. The team responsible for one of       said embryonic stem cell abnormality of a Polycomb target protein methylation is 12 times more likely, this finding of great significance.
Researchers in breast cancer, colorectal cancer, lung cancer and ovarian cancer were found in the study, embryonic stem cells was partially inhibited the gene Polycomb protein, in fact, are pre-made mark, indicating their expression due to methylation be permanently closed. Laird explained that the genes of the "permanent silence" prevents embryonic stem cells, these embryonic stem cells become cancer "seed" the process will be gradual as the development of life, leading to cancer formation.
Laird believe that their study not only the origin of cancer stem cells provide evidence, but also for cancer and the link between experimental embryology provide evidence. "We found that cancer stem cells from the stage of epigenetic changes. This shows that the formation of cancer, epigenetic alterations precede genetic changes." Laird said that this view is relatively new gradually won recognition of scientists.
The next step will focus on what causes some genes inhibit the state transition from temporary into permanent off. If you can prevent the occurrence of this transformation, it is possible to find effective means to treat cancer.
T cell therapy using patient's own cancer
A new study has been launched, the purpose is to achieve using a patient's own immune cells to treat cancer, this research used to be known as "adoptive immunotherapy"). University Hospitals of Cleveland Ireland Cancer Center (*) of the Julian? A.? Kim accepted by the U.S. National Institutes of Health-funded projects, mainly in T cell selection and for the treatment of skin cancer (melanoma ** ) and breast cancer. Research project titled "T cell adoptive immunotherapy of molecular research," research funds for 66 million dollars, the entire study period of 5 years.
In preclinical studies, that the use of human tissue research in the laboratory stage, the researchers will focus on T cells in the lymph nodes in patients with the identification and capture, and in the laboratory by 1 to 2 weeks of time to amplify cells to activate T cells, molecular reagents for interleukin -2 and anti-CD3 antibody (***)。 The pre-clinical studies will help researchers learn how to effective screening and access to T cells, T cells will be handled in a special device for cell growth. Activated T cells will be re-imported the same patient's body, which guide the patient's immune system attacks the body of tumor.
According to Kim's argument, I of the study, 20 patients will participate. "If these trials prove effective, then we can take some similar method of treatment of other types of cancer." Kim said.
Tumor cells can escape death through autophagy
Autophagy: a cell used to organize the contents of the cellular process. Chemotherapy and radiotherapy, a number of tumor cells, autophagy can also occur, but scientists have not known it for this specific role - to help cancer cells to promote tumor cell survival or death? Recently, in a murine B-cell lymphoma study, researchers from the University of Pennsylvania (*) are in fact the researchers show that autophagy is a survival mechanism for tumor cells. The study published in the January 18 of the "Journal of Clinical Investigation" on-line magazine, will be officially launched in February print edition. In this study, the researchers via the expression of activated p53 to induce tumor cell apoptosis. Craig Thompson and colleagues found that autophagy does not occur only in certain tumor cells apoptosis. If the mice, autophagy does not occur, then there will be more apoptotic tumor cells. In addition, in mice with chemotherapy drug cyclophosphamide (**) treatment, the number of tumor cells significantly increased apoptosis, also occurred in significantly shrinking the tumor, tumor recurrence time was significantly delayed. This study has important clinical reference value in tumor cells by apoptosis induced by chemotherapy supplemented by autophagy inhibitors, will increase the success rate of treatment of human cancer.
Note 1: autophagy (autophagy): Autophagy is ubiquitous in most eukaryotic cells, a phenomenon that is phagocytic lysosomal degradation of its structure, it is within the cell recycling system (recycling system .) Autophagy is a clear degradation of key cell structures and damaged cells, aging organelles and other biological macromolecules are no longer needed. Autophagy in the digest, but also for the construction of intracellular organelles to provide raw materials that the recycling of cell structure. Therefore, the equivalent of lysosomal scavenger cells.
Bladder and urethral abnormalities
(A) of the bladder is not developed and not developed bladder often accompanied by hypoplastic kidneys are not developed, so few survivors, a group of 19,046 cases of autopsy data in 7 cases. The literature of 25 cases. Cloacal bladder hypoplasia means retained, the Department of the separation barrier in urine caused by rectal compartment. Ureter terminates in the rectum.
(B) of the Department of embryonic development of bladder disorders repeat the results of the tail part of the embryo due to the students, often accompanied by hindgut duplication. Can be divided into left and right, or up and down both before and after the bladder, gourd-shaped bladder or room. A group of 50% of 18 cases associated with lower gastrointestinal duplication, a
fter a group of 20 cases of intestinal duplication in 60% of repeat bladder. External genitalia associated with the incidence of repetition is also high.






1. Clinical manifestations

3. Imaging

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